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DR. RICHARD EVAN JACKSON MD
NPI 1457359770
Psychiatry & Neurology - Psychiatry in Johnson City, TN

Active since July 11, 2005Opted out of Medicare · through Apr 1, 2028
106 PINNACLE DR, SUITE 107, JOHNSON CITY, TN 37615(423) 328-7332(423) 207-1222 Get Directions Write a Review

NPPES record last updated: July 17, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Richard Evan Jackson Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. RICHARD EVAN JACKSON MD (NPI 1457359770) is an individual psychiatry provider in Johnson City, Tennessee, licensed in Tennessee (15545) and active in the NPI registry since July 2005. He has opted out of Medicare through April 1, 2028.

NPPES Registry Identity

NPI1457359770
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameDR. RICHARD EVAN JACKSONCredential: MD
Location Address106 PINNACLE DR, SUITE 107Johnson City, TN 37615-6602
Mailing Address106 Pinnacle Dr, Suite 107Johnson City, TN 37615-6602 · (423) 328-7332 · Fax (423) 207-1222
Phone(423) 328-7332
Fax(423) 207-1222
Sole ProprietorYes
Enumeration DateJuly 11, 2005
Last NPPES UpdateJuly 17, 2014
✔ NPI 1457359770 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in TN · 15545
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
Also ListedPsychiatry & Neurology · Addiction MedicineTaxonomy 2084A0401X · License 15545 (TN)
106 PINNACLE DR, Johnson City, TN 37615
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Richard Evan Jackson Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 1, 2026 through April 1, 2028.

Opt-Out Effective DateApril 1, 2026
Opt-Out In Effect ThroughApril 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ANGELA JANE SHELTON PHD
Psychologist
106 PINNACLE DR, SUITE 106
JOHNSON CITY, TN 37615
Washington County (423) 525-3771

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Richard Jackson's NPI number?

The NPI number for Richard Jackson is 1457359770. It was assigned to this individual provider in the NPPES registry on July 11, 2005.

Where is Richard Jackson located?

Richard Jackson practices at 106 Pinnacle Dr Suite 107, Johnson City, TN 37615. The listed phone number is (423) 328-7332.

What is Richard Jackson's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Richard Jackson enrolled in Medicare?

No. Richard Jackson has opted out of Medicare through April 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Richard Jackson was last updated on July 17, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.